A statement I have probably heard more variations of in the last two years than in my entire life.
I remember in April 2024, after an event, a lady I had known for a while approached me. She hugged me and said, “Oh my goodness, you look amazing! You’ve lost so much weight, what have you been doing?”
I smiled politely and thanked her. That’s what you do when someone compliments you, right? Especially as a Black woman, you learn how to hold a smile steady while something else is happening entirely.
I know it was well-intended, but it landed like a gut punch. Around that time, I was undergoing tests. The weight loss people were commenting on was not wellness, or discipline, or intentional transformation. My body was changing in response to what would later become a diagnosis of stage 4 Hodgkin lymphoma. She was a fellow Black woman and a mental health nurse, and she did not see it. In fairness, she did not know – but that’s just it. You learn early not to rely on being seen.
This did not stop during treatment and continues even now, a year and a half after finishing chemotherapy and surviving sepsis. During hospital appointments, in conversations with friends and family, even in clinical settings, I often hear some version of the same thing: “you look well”, “you’d never know what you’ve been through”, “it’s so good to see you back to yourself.”
On the surface, these comments are intended as kindness, but over time I have come to understand they are not really about me. They are about other people’s need to resolve what they are seeing in front of them. Statements like “you look great” often translate into ‘you don’t look like you are suffering anymore, so I can stop worrying about you now’. Managing other people’s discomfort around your body is exhausting work, particularly for Black women, who have been doing this for a long time.
Visible illness gives people a script. It shapes what they say, how they behave, how long they feel obligated to engage with it. Once those visible signs fade, something shifts. Recovery becomes socially recognised as return, not just to health, but to normality. The difficult part is assumed to be over, which could not be further from the truth.
Life post-cancer is still punctuated with anxiety, low mood, hyper-vigilance, all symptoms a clinical psychologist described as consistent with post-traumatic stress. None of this is visible in the way people are used to reading illness, so it often does not register. When I could walk, speak, and wear makeup again, the internal reality of what I was experiencing became easier to overlook. Looking well became being well. And while I already knew that Black women’s pain is often taken less seriously in healthcare settings, I had not anticipated how invisible my own recovery would become the moment I started to look like myself again.
This shows up in subtle but consistent ways – people stop checking in, conversations move on. It is not that you want to hold on to illness, but that you are left navigating something you do not fully understand while the rest of the world continues as normal.
In healthcare settings it takes a more direct form, where symptoms are missed or minimised because a person appears physically fine. In both cases, the same assumption is to blame – suffering must be visible to be taken seriously. If you do not look “unwell”, you have to work harder to be believed, performing distress at exactly the moment you have the least capacity to perform anything at all.
For Black women, that work is not new, and it does not start with illness.
Before I had a diagnosis or any explanation for what was happening to my body, I was already navigating a healthcare system that has historically struggled to take Black women’s pain seriously. The belief that we feel less pain, that we are more resilient, less sensitive, more able to endure, was not incidental to the history of medicine, but was built into it. Histories of medical experimentation on Black women’s bodies in the 18th and 19th centuries were shaped by these assumptions. They have not disappeared; they have just taken different forms.
Black maternal mortality is not a historical footnote, it is happening now. Black women are four times more likely to die in childbirth than white women in the UK. In pain management, in mental health, in diagnosis, the pattern is consistent; accounts of our own experience are more likely to be met with doubt, delay, or dismissal.
I have lived this and almost died as a result. During my cancer treatment I collapsed and became unresponsive while in hospital. My mother (a seasoned nurse) was the only person in the room. When she called for help, the response was not immediate. The charge nurse wanted to check my blood sugar first, the healthcare assistant wanted to move a commode out of the way, and my mother was actively discouraged from pulling the emergency buzzer. I was not invisible, yet the urgency was not there. That is not about looking well — it is about whose collapse reads as an emergency and whose does not.
So, when I am told I look great, it does not land the same way. Looking well has often been used as a reason not to look closer, and that has consequences that can cost lives.
Visibility has never been a reliable measure of suffering, and this is where many people fall through the cracks. If care, belief, and access to support remain tied to what can be seen, then there will always be people whose pain does not qualify — not because it is not real, but because the system was not built to recognise it. That is where the question sits for me, still unresolved: what it would mean to believe people before their suffering becomes visible enough to be unquestioned.